With drug overdose deaths on rise, experts push to recognize signs of addiction
Prescription medicine / iStockphoto
Drug addiction can be a hard fact to face and accept, but it's an ongoing problem that needs dire attention.
A new report published in Tuesday's Journal of the American Medical Association shows that drug overdose deaths were on the rise for the 11th straight year. There were a total of 38,329 drug overdose deaths in 2010 according to the Centers of Disease Control and Prevention -- and 60 percent were due to medications, the majority of which were prescription drugs.
Opiod drugs, which include OxyContin and Vicodin, were the most frequently involved, accounting for three out of four medication overdose deaths. Only 17 percent of the deaths were suicides, meaning the vast majority were unintentional overdoses.
"The big picture is that this is a big problem that has gotten much worse quickly," Dr. Thomas Frieden, head of the Centers for Disease Control and Prevention, told the Associated Press.
The first step though is recognizing or helping others recognize that they need help. Some signs that a loved one or a friend might need help include seeing behavioral changes that seem out of the ordinary.
Family members may notice a person's mood swings, altered sleep habits, bizarre behavior including lying and stealing, changes in friends or social groups and unexpected weight loss, Dr. Greg Johnson, a staff physician at Origins Recovery Centers in South Padre Island, Texas, said to CBSNews.com.
For co-workers, this could mean noticing they are becoming less reliable, coming later to work, missing deadlines, isolating themselves in their offices and having more unexcused absences or more absences attributed to illness, Dr. David Sack, CEO of Promises Treatment Centers, told CBSNews.com. They may also have more financial problems like borrowing against their 401Ks or taking money out of their savings. Frequent medical visits for panic attacks or chest palpitations can also be a sign.
Both experts have noticed that younger addicts are seeking treatment -- and believe prescription drugs may be to blame. More adults are on prescription drugs, giving a larger population of children access to them, Johnson pointed out. While alcohol and marijuana still remain "gateway" drugs, he said, young people have easier access to prescription pills from their parent's cabinets. Some start while they are just in middle school.
"A parent may notice at the end of the month, but they may or may not get the idea that their kid is stealing from them," Johnson said.
Sack believes that prescription drug abuse has increased recently because doctors have been prescribing them more freely. While 40 years ago, many physicians held off from giving out pain medication, in the 1970s many medical professionals saw how these pills could help treat pain in people like cancer patients.
"There was a push for a better job of treating all forms of chronic pain," Sack said. "It was a very big initiative around the U.S. and the world."
Frieden added to AP that many doctors and patients don't realize how addictive prescription painkillers can be. He believes they are often given for conditions that could have been managed with less addictive drugs.
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But what people may not realize is that opioids are the same class of drugs as heroin, only in prescription form. The doctors say that they both are seeing more and more people turning to heroin use. Sack believes part of the reason is that after a while opioid drugs can become expensive, and black tar heroin is much cheaper. At that point, many addicts are what Johnson likes to call "polysubstance abusers."
"They'll do Xanax and 'xanibars' if they are here and available, and cocaine if they can get their hands on it, and they'll do heroin if there's heroin," Johnson said.
Sack believes that part of what makes prescription drugs seem safe is that they come from pharmacies and doctors. But, since many prescription narcotics are respiratory depressants, and many people who abuse them use them in conjunction with other depressants like alcohol or sedative hypnotics like Xanax or Ambien, it can lead to negative consequences -- possibly death, Sack said. Johnson has heard of Vicodin, Soma and Xanax referred to as the "Holy Trinity," meaning that drug addicts like to use all three at the same time.
"It's kind of the Heath Ledger phenomenon," Sack explained. "Even though any one of them are not enough to cause an overdose, two or three of theme together is enough."
There are many ways to treat addiction, but all of them come with their risks and benefits. Promises Treatment Centers uses a multifaceted approach of detox, traditional medicine and complimentary treatment like yoga, meditation or acupuncture, and emphasizes community support. For Origins Recovery Centers, they try to aid in drug addiction recovery with a 12-step program and use a mixture of psychiatric, physical and clinical care lasting at least 90 days, with a 24-month follow up period.
"We believe in the concept of if you're treating a disease like you are treating diabetes, you need to have some ongoing care," Johnson explained about Origins' approach. "If you are a diabetic, you wouldn't go to the doctor and be treated for 30 days and then be sent home."
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There's also additional medications that can help a patient wean themselves off an addiction. One method uses Naltrexone, which blocks opioid receptors and stops people from getting high. It can also decrease cravings.
A problem with Naltrexone is that it comes in a daily pill, and sometimes that can be a challenge for addicts to continue with the regiment. Missing a few doses decreases the effectiveness, Sack pointed out. Another version of Naltrexone called Vivitrol only involves a once a month shot, but it can be quite costly, Johnson added. Whereas Sack believes that medications like Naltrexone can be beneficial for people who've had even short term addictions and help them beat them, Johnson thinks that putting addicts on another substance should only be reserved for people who have relapsed many times.
Another form of therapy called medication-assisted or opiate-assisted therapy (also known as maintenance therapy) replaces the drug of choice with other medications like methadone. Since methadone has a longer half-life, people don't experience the euphoria with use like they do when they abuse other drugs like heroin. Still, it can make people addicted to this new substance, so Sack only recommends it for people who repeatedly relapse.
But, the most important part of recovery is recognizing there is a problem.
"The first step is an addict has to hit some type of a bottom or find something that convinces them that they are powerless, that I can no longer do heroin so I have to find another way," Johnson stated.
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